By James Hamblin

The American Psychiatric Association regards Female Orgasmic Disorder as an official diagnosis. It's in the Diagnostic and Statistical Manual, defined as a situation in which a woman is experiencing stress because her "orgasmic capacity is less than would be reasonable for her age, sexual experience, and the adequacy of the sexual simulation she receives."

No matter how the notion of Female Orgasmic Disorder strikes you, someone thinks your opinion is sexist. How we classify and name the aforementioned hypo-orgasmic scenario is passionately, hotly contested. To deny its medical validity is to deny women's right to sexual prosperity; to support it is to put undue onus and the stigma of a "disorder" on women who aren't having orgasms. Both sides believe it affects how we regard and treat women and these symptoms. That's why a nasal-spray called Tefina (in development in Australia and Canada; just approved for phase two trials by Health Canada) designed to treat the condition -- which could initially seem like a win-win-win-win-win proposition -- is actually conspicuously contentious.

It may distract from treating the real etiologies -- focusing on medication when what you really need is tango lessons.

Dr. Susan Davis, chair of Women's Health in the Monash University Department of Medicine in Melbourne, Australia, is the lead researcher on the pharmaceutical company Trimel's trials.
On the CBC radio program The Current, Davis specified that while she doesn't use the term "disorder," she is adamant that there is a spectrum of sexual dysfunction in women -- where they don't reach orgasm -- that can be likened to impotence in men. She says that denying its existence and medical validity is "sexist [and] inappropriate." Men have Viagra/Levitra/Cialis, and women should have an equivalent option.

Tefina is testosterone in the form of a nasal spray, which, like Viagra, dilates blood vessels. One place that happens noticeably is the genitals, where increased blood flow increases sensation. "This dilation increases the capacity for women to experience an orgasm," Davis told The Current. According to her it's been effective in about 60 percent of patients when used prior to sex. Beyond the physiologic mechanism, interestingly, she says testosterone also "has effects on thoughts, desires, and fantasy."

That sounds good, right? Everyone good with that?

Liz Canner agrees with Davis in contesting the use of "disorder," but for a different reason. She believes that giving sexual dysfunction a name like Female Orgasmic Disorder is a byproduct of pharmaceutical company lobbying, created because it sounds more like something that warrants medication. She made an entire documentary about it, called Orgasm Inc.

In a similar but less conspiratorial camp is Dr. Barbara Mintzes, assistant professor in the Department of Anesthesiology, Pharmacology, and Therapeutics at the University of British Columbia. She believes Davis is referring to sexual difficulty. "To call it a medical condition is to misrepresent it," she said on The Current, arguing that "sex is a cultural and psychological event." Testosterone may distract from treating the real etiologies -- focusing on medication when what you really need is dance lessons, Mintzes offers.

Aside from arguments of stigmatization and distraction, this testosterone therapy might not even safely work. Similar treatments have been tried in the U.S. and failed. When Pfizer started profiting massively off of Viagra, there was a well-funded rush to capitalize on a female equivalent. If the answer was this straightforward it does seem like U.S. pharma would have found it. After giving Viagra itself to women, which did not prove effective in clinical trials, there was Intrinsa testosterone patch, which was both ineffective and not approved by the FDA. It was partially approved in Europe but later withdrawn from production, according to Mintzes. She is skeptical that Tefina will be found effective and safe. In which case we would have less to argue about.

We'll keep an expectant eye on Canada for more data from these clinical trials. Ultimately, though, whether this seems like a noble effort to remedy disparities in sexual health or a plot to capitalize on a stigmatizing medical diagnosis, we can at least agree that nasal sprays are inherently alluring and should be used to improve orgasm odds in every possible scenario.